(Beyond Pesticides, November 27, 2012) On Monday, the American Academy of Pediatrics (AAP) released a landmark policy statement, Pesticide Exposure in Children, and an accompanying technical report on the effects of pesticide exposure in children. In the documents, released in the December 2012 issue of Pediatrics magazine and online on November 26, AAP makes note of the current shortfalls in medical training, public health tracking, and regulatory action on pesticides. Acknowledging the risks to children from both acute and chronic effects, AAP’s report provides recommendations to both pediatricians and government health agencies. AAP’s policy statement comes on the heels of an October 2012 report citing the benefits of eating organic food in order to reduce pesticide exposure. Lead authors on the documents for the AAP’s Council on Environmental Health are James R. Roberts, MD, MPH, Medical University of South Carolina, and Catherine J. Karr, MD, PhD, University of Washington.

AAP’s statement notes that, “Children encounter pesticides daily and have unique susceptibilities to their potential toxicity.” The report discusses how kids are exposed to pesticides every day in air, food, dust, and soil. Children also frequently come into contact with pesticide residue on pets and after lawn, garden, or household pesticide applications. The authors explain how diet is likely the main pathway for pesticide exposure in children, citing a 2006 intervention study, which found that switching children to an all-organic diet had an immediate and substantial decrease in the concentration of pesticides in their bodies.

Labeling
Pesticide labels are cited as a specific area of concern in the report. The authors note that current labels do not include the pesticides’ class, a listing of “inert” ingredients in the product, or information on chronic toxicity. AAP recommends pediatricians understand the usefulness and limitations of pesticide information on product labels. The policy statement advises government to require manufacturers to disclosure inert ingredients either on the product’s label or on the company’s web site. AAP also recommends the creation of a “risks to children” section on pesticide labels, which should inform potential applicators whether active or inert ingredients in the product pose chronic or developmental health concerns for children. Beyond Pesticides has long called for the disclosure of inert ingredients in pesticide formulations. A 2009 study showing that the “inert” ingredient in Roundup, polyoxyethyleneamine (POEA), kills human embryonic cells provides additional evidence of this need.

Acute Toxicity
In terms of acute pesticide toxicity, AAP is instructing pediatricians to become more familiar with the various signs and symptoms of exposure. The report states, “Pediatric care providers have a poor track record for recognition of acute pesticide poisoning. This reflects their self-reported lack of medical education and self-efficacy on the topic.” However, AAP also notes that formal data systems that track pesticide exposure incidents are inadequate, and those that track usage trends are outdated (the last national survey on home pesticide use was in 1993). AAP recommends government “make pesticide—related suspected poisoning universally reportable and support a systematic central repository of such incidents to optimize national surveillance.”

Chronic Effects
AAP’s policy statement explains that the past decade has seen an expansion of the evidence showing adverse effects after chronic pesticide exposure. The authors note that the strongest links between pesticides and health effects to children concern pediatric cancer and adverse neurodevelopment. However, low birth weight, preterm birth, congenital abnormalities, cognitive deficits (ADHD, Lower IQ) and asthma are also cited as being pesticide-induced. AAP recommends pediatricians become familiar with the “subclinical” effects of chronic exposures.

General Recommendations
AAP’s policy statement provides a number of general recommendations to pediatricians and government apart from those mentioned above. The authors advise government to set a goal of reducing overall exposure by promoting methods and practices which minimize pesticide contact. AAP explains that government can accomplish this by supporting least toxic pesticide alternatives through integrated pest management (IPM). The statement recommends government provide economic incentives to growers who adopt IPM, and support research to expand IPM in both agriculture and non-agricultural pest control.

The report also recommends government agencies adopt community education and outreach, letting people know when pesticide spraying will occur in public areas. Strengthening procedures and enforcement standards for removing hazardous products is also cited as an area where government should focus its efforts. AAP strongly recommends government require a human biomarker (such as a urinary or blood measure of pesticide concentrations) that could be used to identify exposure or early health implications with new or reregistered products.

The policy statement also encourages government to provide increased education and support to health care providers. This includes providing systems such as Poison Control Centers for timely advice on exposures, and developing diagnostic tests to assist providers with diagnosing pesticide poisoning.

For pediatricians, AAP recommends that providers speak with the parents of their patients about the risks associated with pesticide use, and endorse the use of least-toxic products and IPM methods when possible. The Academy also asks pediatricians to work with schools and government agencies to advocate for IPM principles and a community’s right to know when pesticide sprayings occur. “Pediatricians can play a role in promotion of development of model programs and practices in the communities and schools of their patients,” the AAP policy statement says.

This policy statement is a sobering wake-up call for government agencies and elected officials that our children are not being adequately protected from exposure to toxic compounds. Beyond Pesticides would like to see the AAP recommendations swiftly enacted by government, as well as a broader adoption of organic practices, in order to safeguard the health of future generations.

If you’d like to work with Beyond Pesticides to change the pesticide laws in your community, contact info@beyondpesticides.org or call 202-543-5450. For more information on how pesticides affect kids’ health, refer to our Children and Schools program page.

All unattributed positions and opinions in this piece are those of Beyond Pesticides.